Who Has the Best International Health Insurance: SafetyWing or Genki — or Someone Else Entirely?

We have answers.

Nov 18, 2023

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Update: See my most recent healthcare article here!

Regular readers know that I occasionally write about health insurance for expats, long-term travelers, and nomads like Michael and me.

There are actually two kinds of health insurance for travelers:

Travel Insurance, which is emergency coverage only, is temporary and term-limited.
And Full International Health Insurance — sometimes called “expatriate” or “long-term international” insurance — is full coverage outside your home country. It’s not term-limited, continuing as long as you pay the premiums.

Two companies famous for providing “travel” insurance for nomads — SafetyWing and Genki — have recently started providing “full” international health insurance.

Genki calls it their “Genki Native” plan (as opposed to “Genki Traveler,” which is their travel insurance), and SafetyWing calls it “Nomad Insurance Complete” (as opposed to “Nomad Insurance Essential,” which is their travel insurance).

How do these new-ish plans measure up — and how do they compare to the existing alternatives?

Brent and Michael, near Sydney. — *Staying healthy on the Australian coast.*

Before I get down to the nitty-gritty, here are a few general notes about full international health insurance:

Many international plans require you to declare one country of residence, but they generally provide “world-wide” coverage (except for a few countries, outlined below); always ask for exact details. SafetyWing and Genki both provide coverage virtually everywhere in the world and do not require you to declare your residence in advance.
Because health care is so insanely expensive in America, “world-wide” international coverage works differently in the U.S. (and sometimes in a few other expensive countries or cities, like Canada, Hong Kong, and Singapore). In these places, international policies might only offer emergency coverage (and only for a limited time). You usually have an option to pay for expanded “full” U.S. coverage, but you have to choose this in advance of any illness, and it’s very expensive, probably doubling your premiums. Also, even this “full” coverage might have limitations, unlike in the rest of the world.
No international policy is ACA/Obamacare-compliant; the strict regulations of America’s Affordable Health Care Act are not in effect here. That means you can be denied coverage as a result of a pre-existing condition (or they may charge you more to cover your condition). On the other hand, these policies are still regulated, often in the EU (which has strong legal protections for the consumer). Once you have coverage — and you continue paying your premiums — you usually can’t be dropped because you get sick. But always ask where exactly your insurance company is based and regulated.
Speaking of Obamacare, many American nomads think, “I’ll just carry travel insurance while I travel, and if I get sick, I’ll go home, and I can’t be denied insurance even with a pre-existing condition.” But outside of the annual November enrollment period, you can only get coverage if you have a “qualifying life event.” Moving home for the purpose of receiving medical treatment definitely does not qualify. And if you’re just returning to your previous location — the state where you’ve continued to receive mail and file taxes — that’s not considered a “move” anyway.
In my opinion, all international insurance — travel or full — should have very strong medical evacuation coverage. The added cost to your premium is usually minimal, but medical transport can be very expensive: hundreds of thousands of dollars, or even more if a helicopter is involved. Lacking this coverage can easily bankrupt a person.
Finally, full disclosure: I’m not a medical or insurance expert. I’m just a long-term traveler who has a vested interest in this topic. I’m also an American, although a lot of this information applies to any traveler.

Keeping all this in mind, here are my assessments of SafetyWing’s Nomad Insurance Complete and Genki’s Native plan — followed by some other international insurance options for comparison purposes:

SAFETYWING’S NOMAD INSURANCE COMPLETE

This is a new-ish plan, started in 2023, offering full health insurance world-wide (including the U.S., Singapore, and Hong Kong, if you choose this expensive add-on). It’s complete health care coverage, and can include prescriptions, mental health, pregnancy, and more (with dental as an optional add-on), and it lets you choose any licensed doctor.

It requires a twelve-month contract, which is renewable, but unlike SafetyWing’s travel insurance, you must fill out a medical questionnaire for this plan, and you can be denied coverage.

What I Like:

SafetyWing’s Nomad Insurance Complete is straightforward and fairly affordable. There are no deductibles, and they offer a 10% discount if you pay the year in advance.
Their America, Singapore, and Hong Kong add-on lets you be residents of Hong Kong and Singapore, living there up to twelve months out of the year. But the American coverage only lets you be in that country six months in one year, and while you can be an American to get this add-on, the U.S. can’t be your country of residence.
Unlike most “full” insurance plans (including Genki), they also include some fairly decent non-medical travel protections, such as accommodation cancellation, burglary, and delayed luggage.

What’s the catch?

Pay-outs are capped at $1.5 million in any given year for in-patient (more serious treatments), and $5000 for out-patient (although for surgery, the maximum goes up to $500,000).
There are other caps too. There’s a $300 yearly maximum for routine medical care; wellness treatments are limited to 10 visits at no more than $60 per visit; and maternity care has a $2500 cap, with a 20% deductible, although there’s up to $50,000 for “newborn coverage and maternity complications.”
You cannot get this coverage past age 65 (but if you have the policy, it will continue as long as you continue paying the premiums, which may rise).
Without the add-on, the Standard and Premium plans both limit their coverage in the U.S., Hong Kong, and Singapore to only 30 days per year, and it is a limited, emergency-only coverage.
SafetyWing’s medical evacuation coverage is not great: it maxes out at $100,000 and is more limited than other companies.

Brent’s Take

I wasn’t a huge fan of SafetyWing’s travel insurance, but I like this product better. I like the non-medical travel protections: accommodation cancellation, burglary, delayed luggage, and more.

But the primary advantage is that it’s cheap. The problem is that, while it’s fairly comprehensive coverage, the pay-out limits are low, especially that $5000 out-patient maximum.

And as with their travel insurance, I’m annoyed by their stingy, limited medical evacuation coverage. Keep in mind that if you’re visiting the U.S. — where your coverage may be limited — and suffer a major injury or illness, they may not even transport you back to your home country. Which means you could be stuck without coverage in a country with ridiculously expensive health care.

As a result, if you opt for this policy, consider supplementing it with better evacuation insurance, like Emergency Assistance Plus or DAN diver insurance (which isn’t just for divers). Both of these annual plans are very inexpensive.

Finally, SafetyWing’s America, Singapore, and Hong Kong add-on doesn’t cover Americans living even part-time in America, so it should never be purchased for this purpose.

GENKI NATIVE and GENKI RESIDENT

Genki offers two plans, both of which offer full health insurance world-wide (including the U.S. and Canada, if you choose the expensive “Region 2” add-on). It too is complete health care coverage, and includes prescriptions, dental, mental health, pregnancy, and more. It also lets you choose any licensed doctor.

Genki Native is for folks 55 and under, and Genki Resident is for those older than 55.

But here’s the bottom line: Genki Resident, which is their older plan, is the better, more generous one. If you’re under 55, you should ask if you can get Genki Resident too.

Genki Native and Resident both require a twelve-month contract, which is renewable until death, but once again, you must fill out a medical questionnaire, and you can be denied coverage.

What I Like:

Unlike SafetyWing, Genki Resident has no treatment cap limits. Except for some specific treatments, most of the pay-outs are unlimited, even for out-patient treatments. Genki Native, meanwhile, has a yearly pay-out maximum of $1,087,000 USD. But it doesn’t have SafetyWing’s other maximums; there is no $5000 limit on outpatient treatment, for example.
Genki gives you the option of having no deductible, but they also include options with deductibles (at lower prices). Genki is more expensive than SafetyWing, but in many ways, both plans are a better value. I also have a special “hack” to lower the price, outlined below.

Genki Native tops out at 55, but Genki Resident has no maximum age. You keep this policy as long as you keep paying the premiums (although your premiums will go up dramatically).
The company offers a telemedicine option and 24/7 emergency assistance (which I really like: in remote areas, it can be hard to find reliable health care. Also, you can get your “silly” questions answered).
They include various benefits that other companies don’t, like a $10,000 search-and-rescue pay-out.
Their medical evacuation coverage is very solid. If you’re in an accident, you’ll mostly get to decide where you want to go. That said, if you use this coverage to return to your home country, the expectation is that you will have coverage there, and this policy immediately becomes void.

What’s the catch?

Genki Resident is fantastic coverage, and Genki Native is solid, but they’re both fairly expensive.
Without the Region 2 add-on, coverage in the U.S. and Canada is limited to six weeks a year, and it’s only emergency coverage.
Coverage in your home country, where you’re a resident or citizen, is limited to six months out of every year. Furthermore, you’re not eligible for home country coverage until you leave that country at least once.
There is no discount for paying a year in advance (Genki says it’s because regulations in Europe, where they’re based, do not allow them to charge different people different prices for the same product).
Dentures, tooth and jaw adjustments, childbirth, and psychotherapy may be only partially covered, and aren’t covered at all during the first ten months of insurance; eyesight correction surgeries ($2174 max pay-out per eye) aren’t covered during the first two years of insurance. Except for pregnancy, SafetyWing tells me they don’t have these time limitations — but they have pay-out limits too, and they don’t cover certain procedures, like eyesight correction, at all.

Brent’s Take

Genki Native and (especially) Genki Resident are more comprehensive than SafetyWing’s Nomad Insurance Complete with better pay-outs — and they also have superior medical evacuation coverage. But they’re also more expensive.

That said, the price of Genki Resident (but not Native) can be greatly reduced with one of my secret “travel hacks,” at least if you’re a U.S. resident looking for full U.S. coverage.

Genki Resident offers six months of coverage in your “home country.” But what happens if your home country is the U.S.? Do you still need the U.S. add-on for full coverage there?

No! With Genki Resident, you’ll have six months of full U.S. coverage every year even without the U.S. add-on (assuming you leave the country at least once after starting your policy). This is full U.S. coverage for up to six months for less than half the usual price.

And, yes, this is perfectly legal, and I’ve verified it multiple times (but please: do your own due diligence, and, of course, always get everything in writing).

Bottom line? If you’re an American and you need some full American coverage, Genki Resident is an incredible value. In this respect, it’s superior to SafetyWing, whose full coverage here is literally worthless, at least for Americans.

A few more things to keep in mind about both Genki Native and Genki Resident’s medical evacuation coverage: you can’t use it to return to the U.S. from another country for medical treatment; if you did, Genki’s coverage would end immediately upon arrival. But if you’re already in the U.S., you can use the policy for transportation to a country with cheaper health care, and that health care would be covered — assuming you get prior approval from the company. This is a fantastic perk for nomads.

Comparisons to Other International Plans

When I analyzed “travel insurance” for nomads, my conclusion was clear: Genki seemed like the better value over SafetyWing.

With full international insurance, the picture is a bit more muddled. Safety Wing’s Nomad Insurance Complete has serious limitations, but it’s also fairly cheap.

Meanwhile, both Genki Native and Genki Resident are more robust but also more expensive — especially for more-than-emergency U.S. coverage.

For greater context, I decided it might be helpful to explore the plans of other existing companies.

Unfortunately, every company does things a little — or a lot — differently, so it’s impossible to make direct comparisons. Unlike SafetyWing’s Nomad Insurance Complete and Genki Native, most international plans allow much more customization, raising or lowering deductibles, and adding or eliminating lots of different features. This affects the price — often dramatically.

Of course, price isn’t everything. Value lies in exactly what you’re paying for, not how cheap something is.

First, I looked at Cigna International, a popular choice. These are the premiums for their mid-range Silver Plan, always with medical evacuation coverage (which I think is essential); with and without “out-patient” coverage; and with and without full U.S. coverage in the U.S. (although the non-USA plans include brief emergency coverage).

These numbers are with a $1500 deductible, which can be raised or lowered, changing the premiums.

Cigna premiums. — *Monthly premiums for Cigna Silver, in USD, with a $1500 deductible.*

I looked at Allianz (which is also one of the companies associated with Genki). This is their most basic plan, with a $1015 deductible and includes medical evacuation. I looked at options with and without full U.S. coverage.

Allianz premiums — *Monthly premiums for Allianz, in USD, with a $1015 deductible.*

And I looked at IMG Global Medical Insurance (GMI). These are two different plans, a basic Silver plan, and a more premium plan, Xplorer Premier. These numbers are with a $1000 deductible, and both include medical evacuation. Again, I looked at options with and without full U.S. coverage.

IMG premiums. — *Monthly premiums for IMG Global, in USD, with a $1000 deductible.*

Finally, I looked at GeoBlue, which, frankly, seemed so expensive that I’m assuming I was doing something wrong.

These numbers tell me several things:

The prices for SafetyWing Nomad Insurance Complete, Genki Resident, and Genki Native are all within the ballpark for what other companies are offering and charging (though Nomad Insurance Complete does seem especially stingy on benefits and pay-outs).
Full coverage in the U.S. is really expensive, and for Americans, my above Genki Resident hack is a really good deal.
Prices can vary dramatically based on one’s age, region of coverage, deductible, and specific benefits — and a lot of these exact details are still confusing even to me.

Check out Safety Wing’s Nomad Insurance Complete here.

Check out Genki Native and Resident here.

Update: See my most recent healthcare article here!

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